Abstract
(Purpose) Underweight defined as body mass index (BMI) of less than 18.5kg/m2, is known to be associated with a high mortality rate among all-cause deaths. The purpose was to identify the cohort of patients requiring aggressive nutritional intervention to prevent significant weight loss after total gastrectomy (TG).
(Methods) We reviewed the records of 110 patients undergoing R0 TG for primary gastric cancer between 2007 and 2009. Patients with any incurable factors and those relapsed within 1 years after surgery were excluded from this study. We evaluated the postoperative change of body weight and investigated the clinicopathologic factors affecting a significant underweight at 12 months after TG.
(Results) 39 patients showed a significant weight loss at 12 months after TG. Preoperative BMI of less than 22kg/m2, female gender, Stage ⅡB or more advanced stage and presence of adjuvant chemotherapy were associated with a significant underweight in univariate analysis. Preoperative BMI of less than 22kg/m2, female gender, and presence of adjuvant chemotherapy were chosen as independent risk factors for significant underweight in multivariate analysis.
(Conclusion) Female patients, those with preoperative BMI of less than 22kg/m2 and those undergoing adjuvant chemotherapy are considered to be the candidates for aggressive nutritional intervention after TG.
